Patient History

For two years, the patient complained of pain in the right knee joint, occurring during walking and bending. Under increased loads, the joint swelled, and sleep disturbances due to nighttime pain appeared. In the last two months before visiting the MIBRAR clinic, the condition significantly worsened — pain became constant, limiting daily activities and sports.

Previous conservative treatment (anti-inflammatory medication, physiotherapy) did not provide lasting improvement. A local orthopedist recommended arthroscopic meniscus resection — which the patient declined, seeking alternative treatment.

Diagnosis

Complex tear of the posterior horn of the medial meniscus of the right knee joint — visualized on MRI as a tear line extending into the meniscus body
Patellofemoral cartilage wear — thinning of the patellofemoral joint cartilage
Tibiofemoral cartilage wear — degenerative changes of the medial tibiofemoral compartment
Gonarthrosis grade I–II — early arthrotic changes with joint space narrowing

Surgical Report — MIBRAR® Method

Procedure performed on 03.05.2017 at the MIBRAR clinic (Munich) under Prof. Dr. med. Arsen Babayan. Outpatient, under local anesthesia, without general anesthesia or hospitalization.

Intra-articular transplantation of autologous regenerative concentrates into the right knee joint cavity via microperforations
Intrameniscal transplantation — targeted injection of concentrates directly into the tear zone of the posterior horn of the medial meniscus
CGF (Concentrated Growth Factors) — concentrate enriched with platelets, growth factors, and anti-inflammatory factors, obtained from the patient's venous blood
Lipogems® (microfragmented adipose tissue) — preparation with high concentration of regenerative substances, obtained from the patient's subcutaneous adipose tissue
Injection sites: medial meniscus and right knee joint space

MRI Scans Before and After MIBRAR®

Follow-up MRI was performed 4 weeks after the procedure (30.05.2017). Three pairs of images in different planes of the same patient confirm: MIBRAR® provides full meniscus regeneration — not scarring, but restoration of normal anatomical structure.

Knee MRI: posterior horn medial meniscus tear — before and 4 weeks after MIBRAR®

Images 1–2 (coronal slice): Left — posterior horn medial meniscus tear (green oval), cartilage wear. Right — 4 weeks after MIBRAR®: healed meniscal tissue, new cartilage layer.

Knee MRI sagittal: meniscus regeneration — before and 4 weeks after MIBRAR®

Images 3–4 (sagittal slice): Left — posterior horn meniscus tear line. Tibiofemoral cartilage degeneration. Right — cartilage layer restored, meniscus regenerated without resection.

MRI sagittal: posterior horn meniscus regeneration — before and 4 weeks after MIBRAR®

Images 5–6 (second sagittal slice): Left — tear zone in the posterior horn (green oval), condylar cartilage surface damage. Right — meniscus integrity restored, tear zone filled with new tissue.

Treatment Results

After 1 week

Patient complaints completely ceased. Free movement without limitations — no limp, no crutches, no pain medication.

After 3 weeks

The patient resumed full sports activities without any limitations. Knee swelling did not recur, nighttime pain absent.

After 4 weeks

Follow-up MRI (30.05.2017) confirmed full meniscus regeneration: healed tear tissue, new cartilage layer in the tibiofemoral compartment. Three slices in different planes rule out imaging artifacts.

Long-term

To this day, the patient has no complaints. Participates in sports, leads an active lifestyle without limitations. Arthroscopic resection, previously recommended, was not required.

Why MIBRAR® Instead of Arthroscopy

The standard approach for a complex posterior horn meniscus tear is arthroscopic partial meniscectomy (resection of the damaged part). However, meniscal tissue removal leads to load redistribution in the joint and accelerated arthrosis development: according to meta-analyses, up to 50% of patients after meniscectomy require joint replacement within 15–20 years.

The MIBRAR® method is fundamentally different: instead of removing damaged tissue — stimulating its regeneration with autologous CGF and Lipogems® concentrates. Growth factors from platelets trigger chondrocyte proliferation, while mesenchymal stem cells from adipose tissue differentiate into meniscal and cartilage cells.

In this case, the result is particularly indicative: full meniscus regeneration in 4 weeks — confirmed by three MRI slices — without resection, without arthroscopy, without hospitalization. The patient returned to sports in 3 weeks, while arthroscopy rehabilitation takes 6–8 weeks.